The number of preschoolers requiring extensive dental work suggests that many other parents make the same mistake. The Centers for Disease Control and Prevention noted an increase, the first in 40 years, in the number of preschoolers with cavities in a study five years ago. But dentists nationwide say they are seeing more preschoolers at all income levels with 6 to 10 cavities or more. The level of decay, they added, is so severe that they often recommend using general anesthesia because young children are unlikely to sit through such extensive procedures while they are awake.

There is no central clearinghouse for data on the number of young children undergoing general anesthesia to treat multiple cavities, but interviews with 20 dentists and others in the field of dental surgery suggest that the problem is widespread.

“We have had a huge increase in kids going to the operating room,” said Dr. Jonathan Shenkin, a pediatric dentist in Augusta, Me., and a spokesman for the American Dental Association. “We’re treating more kids more aggressively earlier.”

An apple a day may keep the dentist away, but staying away from the dentist might be a bad move. In fact, it cost the state as much as $5 million each year.

A recent Pew Center report showed more Americans are gambling against routine dental visits. Instead of visiting the dentist for checkups or to get treatment for minor issues, more Americans are ignoring their oral problems.

But when those problems worsen, many of those people are ending up in the emergency room.

In 2007, 10,000 emergency-room visits in Iowa were for oral health reasons — costing the state $5 million. In 2009, there were 14,274 dental visits, with 75 percent adults ages 18 to 44.

Michael Kanellis, the associate dean for patient care at the University of Iowa College of Dentistry, said Iowa doesn't have it as bad as many states in which large urban areas suffer the most, but it's still an issue here.

"With more people out of work, the first thing they will stop spending on is dental care, and so they can end up in the hospital, which isn't good because they will end up with palliative care," said Kanellis, who is also a pediatric dentist.

No one really likes going to the dentist. Apparently more and more people are turning to the doctor instead -- and the economy is to blame.

For some, dental care is not a priority in this tight economy. More people than ever are skipping care all together.

But dentist John Wood will tell you, a little cavity can become a big problem.

“Get a little infection and gets a little worse and a little worse, can swell up and cause a serious problem or some serious pain,” says Dr. John G. Wood from Family Dentistry.

In the last several months, a great number of people in dental agony are winding up in hospital emergency rooms like Maricopa Medical Center in Phoenix.

“The ones we tend to see tend to be agonizing pain. They can’t sleep, they can’t focus on work, so it does interfere with their ability to live their lives,” says Dr. Eric Katz of Maricopa Medical Center.

Dr. Katz says they can only offer a short term pain relief to dental patients.

“Really all we have are pain pills and antibiotics, that’s all were going to do,” says Dr. Katz.

Dr. Katz and Dr. Wood agree that the problem has gotten worse since 2010. That's when AHCCCS, the state health care, cut dental benefits for adults.

Dr. John A. Yagiela, an internationally recognized authority on pain and anxiety control in dentistry, died Feb. 22. Dr. Yagiela, 64, became ill while scuba diving and later died at the Santa Monica University of California-Los Angeles Medical Center.

He is being remembered by his colleagues and friends for his devotion to patient safety and comfort, and his teachings that gave countless dentists a sound foundation in pharmacology.

Dr. Yagiela was a frequent lecturer at dental meetings both nationally and in his home state. After hearing the news of his passing, several organizations announced they would dedicate upcoming meetings and lectures in his memory, including the American Dental Society of Anesthesiology and International Federation of Dental Anesthesiology Societies, the California Dental Society of Anesthesiology, the California Society of Periodontists and the American Society of Dentist Anesthesiologists.